Mounting international concern over Ebola outbreaks in west Africa and an overload of flu cases this winter is raising questions about whether New Zealand is prepared to handle a disease pandemic. Lydia Anderson reports.

At this time of year with flu prevalent, a sneeze from a co-worker is enough to attract questions about whether the employee is well enough to be at work.

Fears of catching the flu are not based on needless paranoia - last month, fit and healthy 47-year-old Christchurch woman Natalie Cadenhead died after weeks battling a lung infection and other influenza symptoms.

Nationally, several hospitals have been inundated with flu cases, stretching staff and bed resources to the limit.

In Auckland, the number of flu cases spiked to twice the national rate, with the medical wards of Middlemore Hospital in South Auckland reaching 13 per cent over-capacity on August 1.


But flu is not the only illness causing public concern.

Overseas, Ebola outbreaks in west African countries are raising all sorts of questions with almost 1000 people dead so far.

The fear of catching Ebola, coupled with global instability, has led to an increased demand for international private jet travel in Europe and the United States, while some airlines have suspended flights to the affected countries.

Ebola is certainly making headlines in New Zealand, but health officials have been quick to point out how hard it would be for the virus to take hold and spread here.

Public Health deputy director Fran McGrath says a case of Ebola here is unlikely."In the event there was a case of Ebola in New Zealand, it would be highly unlikely to cause an outbreak.

"Ebola is not easy to catch; it's not as infectious as the flu or measles. You cannot get Ebola just from sitting next to someone on a plane - it requires contact with infected bodily fluids.

"Because of our geographic isolation and the lack of direct flights from the affected countries, it is unlikely that New Zealand will have a case of Ebola virus disease."

Additionally, Dr McGrath says the affected countries are not common destinations for New Zealand travellers.

If a person suspected of being infected by Ebola entered the country, they would be treated in hospital isolation. "Given the serious nature of the disease, samples would be sent to a high security reference laboratory overseas."

A slice of history

New Zealand might be geographically isolated but it's no stranger to pandemics.

However, the way contagious diseases are managed now is a far cry from the early days.

During New Zealand's settlement years, contagious travellers were often quarantined on islands near main ports.

In 1863, smallpox-infected passengers on board the ship Victory were forbidden to dock in Otago Harbour, and were sent instead to Quarantine Island, which was then used for several decades to treat sick passengers from more than 40 ships.

In Wellington Harbour, Somes Island was used to treat smallpox victims - some of whom were potential settlers who died on the island without ever reaching the mainland.

Quail Island in Lyttelton Harbour was used at different times to quarantine children with diphtheria, and several leprosy sufferers.

Somes and Quail islands were used to treat victims of the 1918-1919 influenza pandemic.

The scale of the so-called Spanish Influenza pandemic, which infected about 40 per cent of the global population and resulted in an estimated 50 million deaths, took New Zealand by surprise. The country had been exposed to influenza before, but the new strain was deadly, killing a total of almost 8600 people in less than two months.

Health authorities co-ordinated a national response to handle the virus, forming a national committee to co-ordinate relief throughout towns across the country.

Officials learnt well from this, and response plans have come a long way since.

Controlling a pandemic

The 2009, H1N1 virus, or swine flu, pandemic killed more than a 250,000 people worldwide, and was recorded as being responsible for 20 deaths here.

In the wake of that outbreak, the Ministry of Health developed a comprehensive influenza pandemic plan based around a six-stage strategy.

The first three action stages are forward planning, border management, cluster control, while the remaining stages focus on pandemic management, post-peak management, and recovery.

According to the plan, an influenza pandemic is the most likely event to cause a large-scale health emergency.

Dr McGrath says a pandemic is caused by a new virus or bacteria that people do not have immunity to, such as a new flu strain, but it has to be able to spread easily.

"You don't have that with Ebola, Ebola isn't easy to spread - it's not spread through the air, like flu or measles "

Kiwis with serious contagious diarrhoea (stomach bugs) or measles are commonly isolated in hospital wards.

"Our health system does that lots and lots of times a day.

"In reality, our health system is much more familiar with isolating people with infectious diseases, we do it all the time."

While the Ministry of Health takes the lead, all hospitals, district health boards, general practices, ambulances and other health services are "very familiar" with national health emergency plans such as the influenza plan, Dr McGrath says.

"They were used across the country in 2009-2010 and used well."

Institute of Environmental Science and Research health programme leader Virginia Hope says while the recent flu outbreaks might seem severe, current influenza activity is in a "normal range" for this time of year.

"The type, spread and effect of influenza tends to change every year which is why it's important to maintain our current levels of surveillance."

Dr McGrath agrees, saying DHBs are experienced at managing the usual influx of patients during winter, and have well-practised plans in place to ensure they have sufficient staff.

The flu vaccine has been extended until August 31, and, while anyone can pay to receive a vaccine, it is free for people aged 65 years and over, pregnant women, and people with long-term health conditions such as severe asthma.

It is also available to children under 5, who have been hospitalised for a respiratory illness, or have a history of significant respiratory illness.

Protect yourself from flu:

• Wash and dry hands often.

• Stay away from people who are sick

• Stay away from work or school if unwell.

• Cover coughs and sneezes.